{"title":"Combined Clomiphene Citrate-Metformin Versus Letrozole-Metformin in Achieving Pregnancy among Women with Polycystic Ovary Syndrome","authors":"S. U, Shrestha S, D. R","doi":"10.33425/2639-9342.1071","DOIUrl":"https://doi.org/10.33425/2639-9342.1071","url":null,"abstract":"","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83510603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Gassama, B. Biaye, Aminata Niass, M. Cissé, Altaweel Ar, M. Diallo, A. Diouf, P. Moreira, J. Moreau
Objectives: To evaluate the efficacy of treatment with methotrexate, and the possibility of medical treatment of living embryo. Observation: We report two cases in secondary amenorrhea of 6 weeks received in an algebra table associated with minimal bleeding. The physical examination had found moderate pain in the left iliac fossa for the first patient and for the second patient in the right iliac fossa with minimal bleeding. The first endo-vaginal ultrasound showed a left lateral uterine mass, the second one a right lateral uterine mass containing a living embryo of sixweek amenorrhea. We administered a triple dose of methotrexate to both patients whose improvement could be noticed trough a clinical remission and a decrease of the plasmatic βHCG level. Consequently, we decided to release them after 8 days of hospitalization. Conclusion: The medical treatment of tubal ectopic pregnancy with living embryo is difficult due to the work conditions; furthermore, it is a controversial issue in our country.
{"title":"Medical Treatment of Tubar Ectopic Pregnancy with Living Embryo: About Two Cases in Dakar (Senegal)","authors":"O. Gassama, B. Biaye, Aminata Niass, M. Cissé, Altaweel Ar, M. Diallo, A. Diouf, P. Moreira, J. Moreau","doi":"10.33425/2639-9342.1073","DOIUrl":"https://doi.org/10.33425/2639-9342.1073","url":null,"abstract":"Objectives: To evaluate the efficacy of treatment with methotrexate, and the possibility of medical treatment of living embryo. Observation: We report two cases in secondary amenorrhea of 6 weeks received in an algebra table associated with minimal bleeding. The physical examination had found moderate pain in the left iliac fossa for the first patient and for the second patient in the right iliac fossa with minimal bleeding. The first endo-vaginal ultrasound showed a left lateral uterine mass, the second one a right lateral uterine mass containing a living embryo of sixweek amenorrhea. We administered a triple dose of methotrexate to both patients whose improvement could be noticed trough a clinical remission and a decrease of the plasmatic βHCG level. Consequently, we decided to release them after 8 days of hospitalization. Conclusion: The medical treatment of tubal ectopic pregnancy with living embryo is difficult due to the work conditions; furthermore, it is a controversial issue in our country.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80042217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rolanda Lister, Etoi Garrison, Francine Hughes, Scott Baldwin, Bin Zhou
Objectives: To study the incidence of congenital heart defects (CHD) in offspring born to hyperglycemic mothers with and without ovarian stimulation.
Design: Reproductive biology.
Setting: Mouse model.
Patients: N/A.
Intervention: Hyperglycemia was induced in CD-1 wild type female mice using a single intraperitoneal dose of 150 mg/kg of streptozotocin. Stimulated dams (SD); (n=3) were injected with pregnant mare serum and human chorionic gonadotropin 48 hours apart. Non-stimulated dams (NSD); (n=4) were not injected. Both groups were mated with normal male CD-1 mice for timed pregnancies. Fetal hearts were extracted on embryonic day 16.5 and histological analyses was performed. Student's t-tests were employed to compare the incidence of cardiac defects in the SD and NSD groups. P ≤ 0.05 was significant.
Main uutcome measure: The incidence of CHD in progeny of diabetic dams with and without ovarian hyperstimulation.
Results & conclusions: The average litter size was higher in SD compared to NSD. The average blood glucose for the SD and NSD was similar. Overall, the incidence of cardiac malformations did not differ between the two groups. However, in severe maternal hyperglycemia (>400 mg/dL), there was a higher incidence of fetal cardiac malformations in the pups born to SD vs NSD.
{"title":"Ovarian Stimulation Increases the Risk of Fetal Cardiac Defects of Pups Exposed to Severe Maternal Hyperglycemia.","authors":"Rolanda Lister, Etoi Garrison, Francine Hughes, Scott Baldwin, Bin Zhou","doi":"10.33425/2639-9342.1074","DOIUrl":"10.33425/2639-9342.1074","url":null,"abstract":"<p><strong>Objectives: </strong>To study the incidence of congenital heart defects (CHD) in offspring born to hyperglycemic mothers with and without ovarian stimulation.</p><p><strong>Design: </strong>Reproductive biology.</p><p><strong>Setting: </strong>Mouse model.</p><p><strong>Patients: </strong>N/A.</p><p><strong>Intervention: </strong>Hyperglycemia was induced in CD-1 wild type female mice using a single intraperitoneal dose of 150 mg/kg of streptozotocin. Stimulated dams (SD); (n=3) were injected with pregnant mare serum and human chorionic gonadotropin 48 hours apart. Non-stimulated dams (NSD); (n=4) were not injected. Both groups were mated with normal male CD-1 mice for timed pregnancies. Fetal hearts were extracted on embryonic day 16.5 and histological analyses was performed. Student's t-tests were employed to compare the incidence of cardiac defects in the SD and NSD groups. P ≤ 0.05 was significant.</p><p><strong>Main uutcome measure: </strong>The incidence of CHD in progeny of diabetic dams with and without ovarian hyperstimulation.</p><p><strong>Results & conclusions: </strong>The average litter size was higher in SD compared to NSD. The average blood glucose for the SD and NSD was similar. Overall, the incidence of cardiac malformations did not differ between the two groups. However, in severe maternal hyperglycemia (>400 mg/dL), there was a higher incidence of fetal cardiac malformations in the pups born to SD vs NSD.</p>","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7377632/pdf/nihms-1596144.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38189079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-31DOI: 10.4172/2325-9795-C2-012
K. Kajihara
Background: The maternal and child health (MCH) handbook is the original one in Japan, and its historical dates back before the war. Along with the amendment of the law, the maternal and child health program was also strengthened and the MCH handbook had changed not only the name but also its contents. Purpose: I will review the history of MCH handbook and clarify the purpose of establishing MCH handbook. Method: It is the examination of the prior documents and papers. I looked up the documents and original articles not to assign the age. Results: I looked up the 42 articles but the target of the examination of analysis were 12 original articles. Conclusion: In 1926, infant mortality was 289,275 and neonatal mortality was 119,624 in Japan. And furthermore, flow number to be prematurely delivered of a child was almost 300,000 and maternal death by deliver was 5,000 per year. In 1940, maternal mortality rate was 239.6 per child birth 100,000. The origin of the maternal and child health book was “Mutterpass” from Germany. “Mutterpass” consisted first half of the book was for the first baby and last half of the book was for the second baby. In Japan, MCH handbook consisted for the pregnant women and the one baby to manage their health condition. World War the second was the turning point of the health service and public health administration of Japan. Especially maternity health administration was promoted by the government and they expand the range of the MCH handbook. From 1948, the MCH handbook was covered and managed in one book from pregnancy period and their children. We have promoted the notebook system by continuing these advantages and enhancing the contents.
{"title":"Historical Transition and Advantage of Maternal and Child Health Book in Japan","authors":"K. Kajihara","doi":"10.4172/2325-9795-C2-012","DOIUrl":"https://doi.org/10.4172/2325-9795-C2-012","url":null,"abstract":"Background: The maternal and child health (MCH) handbook is the original one in Japan, and its historical dates back before the war. Along with the amendment of the law, the maternal and child health program was also strengthened and the MCH handbook had changed not only the name but also its contents. Purpose: I will review the history of MCH handbook and clarify the purpose of establishing MCH handbook. Method: It is the examination of the prior documents and papers. I looked up the documents and original articles not to assign the age. Results: I looked up the 42 articles but the target of the examination of analysis were 12 original articles. Conclusion: In 1926, infant mortality was 289,275 and neonatal mortality was 119,624 in Japan. And furthermore, flow number to be prematurely delivered of a child was almost 300,000 and maternal death by deliver was 5,000 per year. In 1940, maternal mortality rate was 239.6 per child birth 100,000. The origin of the maternal and child health book was “Mutterpass” from Germany. “Mutterpass” consisted first half of the book was for the first baby and last half of the book was for the second baby. In Japan, MCH handbook consisted for the pregnant women and the one baby to manage their health condition. World War the second was the turning point of the health service and public health administration of Japan. Especially maternity health administration was promoted by the government and they expand the range of the MCH handbook. From 1948, the MCH handbook was covered and managed in one book from pregnancy period and their children. We have promoted the notebook system by continuing these advantages and enhancing the contents.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81830615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Biaye, M. Diallo, A. Mbodji, Aminata Niass, M. Guèye, Kane Gueye Sm, A. Diouf
Introduction: Dermatofibrosarcoma is a sarcoma of intermediate degree of malignancy with strong local aggressiveness with a low but real metastatic potential. Its breast location is very rare. Observation: It was a 40-year-old woman who has never been pregnant who was followed for a retro-areolar tumor of the ulcerated left breast that had been evolving for more than eight weeks. A mammary cytopract was done which was in favor of a phyllode tumor. We performed a large surgical excision on the patient and the histology of the operative specimen was in favor of a dermatofibrosarcoma of Darier and Ferrand with healthy resection margins. Discussion: The mammary location of Darier and Ferrand syndrome is rare. With early diagnosis an infectious and hemorrhagic complication can be avoided whereas, wide excision improves the prognosis.
{"title":"Darier and Ferrand Dermatofibrosarcoma with Mammary Location: About a Case","authors":"B. Biaye, M. Diallo, A. Mbodji, Aminata Niass, M. Guèye, Kane Gueye Sm, A. Diouf","doi":"10.33425/2639-9342.1062","DOIUrl":"https://doi.org/10.33425/2639-9342.1062","url":null,"abstract":"Introduction: Dermatofibrosarcoma is a sarcoma of intermediate degree of malignancy with strong local aggressiveness with a low but real metastatic potential. Its breast location is very rare. Observation: It was a 40-year-old woman who has never been pregnant who was followed for a retro-areolar tumor of the ulcerated left breast that had been evolving for more than eight weeks. A mammary cytopract was done which was in favor of a phyllode tumor. We performed a large surgical excision on the patient and the histology of the operative specimen was in favor of a dermatofibrosarcoma of Darier and Ferrand with healthy resection margins. Discussion: The mammary location of Darier and Ferrand syndrome is rare. With early diagnosis an infectious and hemorrhagic complication can be avoided whereas, wide excision improves the prognosis.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75275930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Trichoepithelioma is very rare and benign skin lesion. It is arising from hair follicles. [1] This slowly growing cutaneous tumour most commonly arises on the face and scalp, neck and trunk, and usually presents clinically as single or multiple nodules. It is exceptionally rare on the vulva. Vulvar trichoepithelioma has complex histologic patterns. It originates in appendages that simulate malignancy. [2] There were only a few previous reports of cases, of such a tumour occuring on the vulva [1-3]. Case Report A 30-year-old women was referred with 5-year history of bothsided vulvar tumours multiple nodules, which had increased in size. On examination there were many small nodules localized under the skin of the labia majora, laying along its top margin (Figure 1). There were no other symptoms, or lymphadenopathy, but on the other hand, the patient was not well. She had decreased self-esteem and was ashamed of her appearance. She had one child birth in her past medical history and she planned to have another one, but in her opinion, it was impossible in such situation. She decided to remove tumours first. These psychological symptoms were the main reason of taking the decision for choosing the plastic surgical technique of excision the lession. It was excised under general anaesthesia. After beeing marked, the tumour was excised with RF tool. Left edges of the wound were smooth, without signs of nodules. The histology reported micronodular trichoepithelioma. Because of patient will, simultaneously with labia majora plastic surgery, the resection of left labia minora was performed (posteror wedge resection). On review the wounds were well healed. First control was presented 4 weeks after surgery. Patient was very well and satisfied of the plastic results. Proper shape of the vulva was preserved and no disturbances were reported by the patient (Figure 2).
{"title":"Trichoepithelioma of the Vulva - Plastic Surgery Treatment - Case Report","authors":"R. Kuźlik, R. Karwowski","doi":"10.33425/2639-9342.1065","DOIUrl":"https://doi.org/10.33425/2639-9342.1065","url":null,"abstract":"Trichoepithelioma is very rare and benign skin lesion. It is arising from hair follicles. [1] This slowly growing cutaneous tumour most commonly arises on the face and scalp, neck and trunk, and usually presents clinically as single or multiple nodules. It is exceptionally rare on the vulva. Vulvar trichoepithelioma has complex histologic patterns. It originates in appendages that simulate malignancy. [2] There were only a few previous reports of cases, of such a tumour occuring on the vulva [1-3]. Case Report A 30-year-old women was referred with 5-year history of bothsided vulvar tumours multiple nodules, which had increased in size. On examination there were many small nodules localized under the skin of the labia majora, laying along its top margin (Figure 1). There were no other symptoms, or lymphadenopathy, but on the other hand, the patient was not well. She had decreased self-esteem and was ashamed of her appearance. She had one child birth in her past medical history and she planned to have another one, but in her opinion, it was impossible in such situation. She decided to remove tumours first. These psychological symptoms were the main reason of taking the decision for choosing the plastic surgical technique of excision the lession. It was excised under general anaesthesia. After beeing marked, the tumour was excised with RF tool. Left edges of the wound were smooth, without signs of nodules. The histology reported micronodular trichoepithelioma. Because of patient will, simultaneously with labia majora plastic surgery, the resection of left labia minora was performed (posteror wedge resection). On review the wounds were well healed. First control was presented 4 weeks after surgery. Patient was very well and satisfied of the plastic results. Proper shape of the vulva was preserved and no disturbances were reported by the patient (Figure 2).","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88672874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Biaye, O. Gassama, Niassy Ac, Mactar Faye, Youssoupha Touré, P. Moreira, J. Moreau
Maternal tetanus is the development of Clostridium tetani in the maternal organism due to unsanitary practices during childbirth or abortion. It has become a rare condition since the introduction of tetanus toxoid vaccination in pregnant women. We report a case of genital tetanus in a 32-year-old patient in Nabil Choucair Health Center, Dakar, Senegal. Through this case, we will present a review of the literature on the epidemiological, clinical, and prognostic aspects of this condition.
{"title":"A Case of Maternal Tetanos Following Illegal Induced Abortion","authors":"B. Biaye, O. Gassama, Niassy Ac, Mactar Faye, Youssoupha Touré, P. Moreira, J. Moreau","doi":"10.33425/2639-9342.1068","DOIUrl":"https://doi.org/10.33425/2639-9342.1068","url":null,"abstract":"Maternal tetanus is the development of Clostridium tetani in the maternal organism due to unsanitary practices during childbirth or abortion. It has become a rare condition since the introduction of tetanus toxoid vaccination in pregnant women. We report a case of genital tetanus in a 32-year-old patient in Nabil Choucair Health Center, Dakar, Senegal. Through this case, we will present a review of the literature on the epidemiological, clinical, and prognostic aspects of this condition.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82685623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Biaye, O. Gassama, F. Me, A. Niass, A. Mbodji, M. Dialo, A. Diouf
{"title":"Uterine Rupture Case Study at Kolda Regional Hospital Center","authors":"B. Biaye, O. Gassama, F. Me, A. Niass, A. Mbodji, M. Dialo, A. Diouf","doi":"10.33425/2639-9342.1067","DOIUrl":"https://doi.org/10.33425/2639-9342.1067","url":null,"abstract":"","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78976660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qiong Da, Jianqiong Liu, Bei Liu, Yanqin Wang, Yukai Du
Objective: To assess the relationship between traits coping style, social support and Quality of Life (QOL) of breast cancer surgery by Canonical Correlation Analysis (CCA). Methods: 400 breast cancer surgery before a week were interviewed with traits coping style questionnaire (TCSQ), social support rating scale (SSRS) and Chinese Version of functional assessment of cancer therapy (FACT-B V 4.0), in which they were asked to recall major events and their corresponding feelings. Results: There was statistical significance for the model of CCA (P<.0001). The first set of linear combination of typical variables after standardization, the standardized linear combination of the first pair of typical variables are as following: V1=0.5466 x1-0.1499 x2+0.5107 x3+1.1313 x4+0.3916 x5+1.3175 x6. The second set of linear combination of typical variables after standardization, the standardized linear combination of the first pair of typical variables are as following: U1=-0.3402y1+0.2092y2+0.1619y3+0.0322y4-0.1358y5+0.9530y6. Conclusion: Traits coping style and social support were associated with QOL of breast cancer surgery.
目的:应用典型相关分析(CCA)探讨乳腺癌手术患者特质、应对方式、社会支持与生活质量(QOL)的关系。方法:采用特质应对方式问卷(TCSQ)、社会支持评定量表(SSRS)和中文版癌症治疗功能评价量表(FACT-B V 4.0)对400例乳腺癌手术前1周的患者进行问卷调查，要求其回忆重大事件及相应感受。结果:CCA模型差异有统计学意义(P< 0.0001)。标准化后的第一组典型变量的线性组合，标准化后的第一对典型变量的线性组合如下:V1=0.5466 x1-0.1499 x2+0.5107 x3+1.1313 x4+0.3916 x5+1.3175 x6。标准化后的第二组典型变量的线性组合，第一对典型变量的标准化线性组合如下:U1=-0.3402y1+0.2092y2+0.1619y3+0.0322y4-0.1358y5+0.9530y6。结论:特质、应对方式和社会支持与乳腺癌手术患者的生活质量有关。
{"title":"Study on the Relationship between Coping Style, Social Support and Quality of Life in Breast Cancer Surgery","authors":"Qiong Da, Jianqiong Liu, Bei Liu, Yanqin Wang, Yukai Du","doi":"10.33425/2639-9342.1061","DOIUrl":"https://doi.org/10.33425/2639-9342.1061","url":null,"abstract":"Objective: To assess the relationship between traits coping style, social support and Quality of Life (QOL) of breast cancer surgery by Canonical Correlation Analysis (CCA). Methods: 400 breast cancer surgery before a week were interviewed with traits coping style questionnaire (TCSQ), social support rating scale (SSRS) and Chinese Version of functional assessment of cancer therapy (FACT-B V 4.0), in which they were asked to recall major events and their corresponding feelings. Results: There was statistical significance for the model of CCA (P<.0001). The first set of linear combination of typical variables after standardization, the standardized linear combination of the first pair of typical variables are as following: V1=0.5466 x1-0.1499 x2+0.5107 x3+1.1313 x4+0.3916 x5+1.3175 x6. The second set of linear combination of typical variables after standardization, the standardized linear combination of the first pair of typical variables are as following: U1=-0.3402y1+0.2092y2+0.1619y3+0.0322y4-0.1358y5+0.9530y6. Conclusion: Traits coping style and social support were associated with QOL of breast cancer surgery.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84379573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: To study the relationship between HIV infection, antiretroviral therapy and CD4 lymphocyte counts on the ovarian reserve. Design: A retrospective cohort study. Setting: The study was conducted at a fertility centre in Johannesburg. Patients: The study group comprised of HIV positive patients undergoing IVF treatment. The control groups were HIV negative patients who were also undergoing IVF treatment. The study group was further subdivided into patients on ARV treatment and those who were not on treatment. Interventions: Comparisons were made between the study and control groups and between the two arms of the study group with regards to outcome measures. Main Outcome Measures: 1) Ovarian reserve using anti-műllerian hormone (AMH) levels and antral follicle count (AFC) as biomarkers, and 2) pregnancy outcomes. Results: A total of 79 study patients underwent IVF treatment; 75 achieved embryo transfer and 21 pregnancies were obtained. Of the patients who achieved pregnancy, only one had a CD4 count < 200. Of the 21 patients who achieved pregnancy, 9 were not on prior ARV treatment and 12 were on ARV treatment. The HIV seropositive group had statistically lower AMH levels when compared with the expected age related AMH levels (p = 0.011). Comparing the two arms in the study group, treatment with ARV therapy was also noted to statistically affect AMH levels (p = 0.045). Significantly fewer pregnancies were noted in the HIV positive group (28% vs 34.5%) and there were more pregnancies amongst those on ARV treatment compared with those who were not on treatment, but this was not statistically significant (57% vs 43%). Conclusion: The mechanism by which HIV infection influences AMH and ovarian reserve remains speculative. In our study we demonstrated that HIV infection has a negative effect on ovarian reserve and the fact that the majority of those who conceived had a CD4 >200 suggests that CD4 counts may influence conception.
{"title":"Effects of Human Immunodeficiency Virus Infection and Antiretroviral Therapy on Ovarian Reserve and Invitro Fertilisation Success","authors":"Mohamed Iqbal Cassim, T. Mohamed","doi":"10.33425/2639-9342.1063","DOIUrl":"https://doi.org/10.33425/2639-9342.1063","url":null,"abstract":"Objectives: To study the relationship between HIV infection, antiretroviral therapy and CD4 lymphocyte counts on the ovarian reserve. Design: A retrospective cohort study. Setting: The study was conducted at a fertility centre in Johannesburg. Patients: The study group comprised of HIV positive patients undergoing IVF treatment. The control groups were HIV negative patients who were also undergoing IVF treatment. The study group was further subdivided into patients on ARV treatment and those who were not on treatment. Interventions: Comparisons were made between the study and control groups and between the two arms of the study group with regards to outcome measures. Main Outcome Measures: 1) Ovarian reserve using anti-műllerian hormone (AMH) levels and antral follicle count (AFC) as biomarkers, and 2) pregnancy outcomes. Results: A total of 79 study patients underwent IVF treatment; 75 achieved embryo transfer and 21 pregnancies were obtained. Of the patients who achieved pregnancy, only one had a CD4 count < 200. Of the 21 patients who achieved pregnancy, 9 were not on prior ARV treatment and 12 were on ARV treatment. The HIV seropositive group had statistically lower AMH levels when compared with the expected age related AMH levels (p = 0.011). Comparing the two arms in the study group, treatment with ARV therapy was also noted to statistically affect AMH levels (p = 0.045). Significantly fewer pregnancies were noted in the HIV positive group (28% vs 34.5%) and there were more pregnancies amongst those on ARV treatment compared with those who were not on treatment, but this was not statistically significant (57% vs 43%). Conclusion: The mechanism by which HIV infection influences AMH and ovarian reserve remains speculative. In our study we demonstrated that HIV infection has a negative effect on ovarian reserve and the fact that the majority of those who conceived had a CD4 >200 suggests that CD4 counts may influence conception.","PeriodicalId":12828,"journal":{"name":"Gynecology & reproductive health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89440107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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