Summary Polycystic ovary syndrome (PCOS) is a condition that affects fertility. There are two types of PCOS; the normal/lean type and overweight/obese type. The aim of this study was to assess baseline characteristics, ovarian response, quality of oocytes, embryos, pregnancy, implantation and live birth rates in normal/lean and overweight/obese patients with PCOS undergoing ICSI compared with patients without PCOS. This retrospective case–control analytical study included 38 normal/lean and 17 overweight/obese patients with PCOS, and 98 normal/lean and 17 overweight/obese patients without PCOS. Parameters were observed based on baseline characteristics, ovarian response to dosage and duration of gonadotropin administered, number of oocytes, matured oocytes, fertilization rate, embryo quality and development, pregnancy, implantation and live birth rates. Basal serum luteinizing hormone in normal/lean PCOS was significantly higher compared with non-PCOS groups. Total dosage of gonadotropin used was significantly lower in normal/lean PCOS compared with other groups. End estradiol levels in normal/lean PCOS was significantly higher compared with the non-PCOS groups. Number of follicles, retrieved oocytes and matured oocytes were significantly higher in PCOS groups compared with the non-PCOS groups. However, there were no differences in fertilized oocytes, cleavage, number of top-quality embryos, pregnancy, implantation, and live birth rates among groups. This present study suggests that normal/lean PCOS requires lower gonadotropin dosages and that patients with PCOS have more follicles and oocytes compared with patients without PCOS, however the number of fertilized oocytes and embryos from patients with PCOS were the same as those from patients without PCOS and suggested that the quality of retrieved oocytes in PCOS might be compromised.
Endometriosis is a disease of theories, but none has succeeded to explain the whole picture. Most widely available drugs for endometriosis aim to relieve symptoms and improve fertility. Unfortunately, many short and long-term side-effects are associated with the treatments. To overcome this problem, researchers have developed many novel therapeutic agents, including non-invasive technique. We aim to provide new insights on pathogenesis model and novel non-surgical treatments for endometriosis, including drugs already available in the market and also drugs which are still under research. Seven novel treatment modalities are recognized, namely dienogest, aromatase inhibitor (AI), gonadotrophine-releasing hormone (GnRH) antagonist, anti tumor necrosing factor (TNF)-α, selective estrogen receptor modulator (SERM), selective progesterone receptor modulator (SPRM), and high-intensity focused ultrasound (HIFU). Dienogest, AI, and GnRH antagonists are effective novel treatments with good tolerance and safety. SERM and SPRM show inconsistent results, while anti-TNF-α is still in the animal experimental stage. HIFU is a potential futuristic treatment. However, it is still a long way until this technology is truly applicable.
Introduction: Infertility is the inability to get pregnant after 12 months or more without using contraception and is primary where the couple fails to get a pregnancy to continue the offspring. Infertility can be caused by factors of women, men or both. Around 50-80 million couples experience infertility in the world, infertility in developing countries is higher, which is around 30%, compared to developed countries, only 5-8%. Method: This research is a cross-sectional descriptive study. The source of the data comes from secondary data, namely medical records of patients experiencing infertility at the clinic visiting Sanglah Hospital for the period January 2016-December 2017. Data collection was taken by the Total Sampling method. The distribution of research variables is in women with tubal, uterine and ovarian factors whereas in men it is sperm factor. Result: Infertility events at Sanglah General Hospital Denpasar in January 2016-December 2017 were 38 cases. In women, the factor of one non-patent tube were 4 cases (25.0%), and respondents with both non-patent tubes were 12 cases (75.0%). Ovarian factor abnormalities, Endometrioma were 2 cases (12.5%). There were no cases of Uterine factor abnormalities in Women. Infertility in men based on sperm factors: 1 case oligozoospermia (5.6%), Asthenozoospermia 2 cases (11.1%), Teratozoospermia 1 case (5.6%), Oligo Astheno Teratozoospermia 11 cases (61.1%) and Azoospermia 3 cases (16.7%). Conclusion: The highest factor of infertility in women is abnormalities in the tube, both tubal non-patent. The highest cause of infertility in men is an abnormality in sperm, Oligo-Astheno-Teratozoospermia.
Background: Preeclampsia and eclampsia have been increasing at an alarming rate. It is a challenging task for doctors and pregnant mothers. Preeclampsia defined as new onset of hypertension (≥140mmHg systolic or ≥90mm Hg diastolic on at least two occasions 6 hours apart) and proteinuria (at least 1+ on dipstick or ≥300mg in a 24-hour urine collection) after 20 weeks of gestation. Eclampsia defined as neurologic involvement in the form of generalized tonicclonic convulsions in women with preeclampsia is termed eclampsia if the seizures cannot be attributed to any other cause such as epilepsy, cerebral infection, tumor or ruptured aneurysm. Aim: This study aims to find the association of risk factors for preeclampsia and eclampsia. The risk factors for preeclampsia and eclampsia are obesity, primigravida, multiple pregnancies, diabetes, pre-existing hypertension, family history, expecting mother's age, nutritional status, and socioeconomic status. The study was carried out by using descriptive research and data were collected from medical records in Sanglah hospital which has 140 cases. Results: The results for preeclampsia are highest in expecting the age of 20-35 years old, primigravida women with gestational age > 37 weeks, overweight and overnourished women, a middle socioeconomic status and also without risk factors. The results for eclampsia are dominant in expecting age of 20-35 years old, primigravida women with gestational age > 37 weeks, women with middle socioeconomic status and majority without risk factors, and women who are overweight and overnourished. Conclusion: Preeclampsia and eclampsia cases are highest in expecting age of 20-35 years old, primigravida women with gestational age >37 weeks, overweight and overnourished women, majority women without risk factors and from middle socioeconomic status.
Introduction: Preterm labor is one of the major problem and challenge in the obstetric field, since it is associated with high mortality and morbidity in newborn. Preterm delivery around 39.6% was thought to be caused by infection. One of the most common causes of preterm labor is Urinary Tract Infection (UTI). This study aims to determine the role of UTI in pregnancy as a risk factor for preterm labor.Method: This study is a case control study conducted from February 2019 to November 2019. This study involved 52 women (26 case group and 26 control group) with gestational ages over 20 weeks and under 37 weeks, where in case group with signs and symptoms of threatened of preterm delivery and in control group with no signs and symptoms of threatened of preterm delivery. The research sample is maternal peripheral blood for evaluation of Haemoglobin and mid stream urine for evaluation of Bacteriuria and Urine Culture - Resistance Test. Result: In this study, there were no differences in the value of characteristics of maternal age, gestasional age, and gravidity between the two groups (p> 0.05). Pregnancy with UTI (asymptomatic bacteriuria) increased the risk of preterm labor by 13 times compared to pregnancies without UTI (OR = 13.24; 95% CI = 1.53-114.30; p = 0.005 ).Conclusion: Based on the results of this study it can be concluded that a pregnancy with a UTI has a 13 times higher risk of experiencing preterm labor when compared to a pregnancy without a UTI.  Pendahuluan: Persalinan preterm adalah salah satu masalah dan tantangan dalam bidang obstetrik, terkait dengan tingginya mortalitas dan morbiditas pada bayi yang dilahirkan. Persalinan preterm sekitar 39,6% disebabkan oleh infeksi. Salah satu penyebab yang paling umum adalah Infeksi Saluran Kemih (ISK). Penelitian ini bertujuan untuk mengetahui peranan ISK dalam kehamilan sebagai faktor risiko terjadinya persalinan preterm.Metode: Penelitian ini adalah studi kasus kontrol yang dilakukan dari Februari 2019 hingga November 2019. Penelitian ini melibatkan 52 wanita (26 kelompok kasus dan 26 kelompok kontrol) dengan usia kehamilan lebih dari 20 minggu dan di bawah 37 minggu, di mana dalam kelompok kasus dengan adanya tanda dan gejala ancaman persalinan preterm dan dalam kelompok kontrol tanpa adanya tanda dan gejala ancaman persalinan preterm. Sampel penelitian adalah darah tepi ibu untuk keperluan menilai kadar Hemoglobin dan urin aliran tengah untuk keperluan evaluasi adanya Bakteriuria dan selanjutnya untuk Kultur Urin – Uji Resistensi.Hasil: Dalam penelitian ini, diketahui bahwa tidak ada perbedaan bermakna dalam karakteristik usia ibu, usia kehamilan, dan graviditas antara kedua kelompok (p>0,05). Diketahui bahwa kehamilan dengan ISK (bakteriuria asimptomatik) meningkatkan risiko persalinan preterm sebesar 13 kali dibandingkan dengan kehamilan tanpa ISK (OR = 13,24; IK 95%= 1,53-114,30; p = 0,005).Simpulan: Berdasarkan hasil penelitian ini disimpulkan bahwa kehamilan dengan ISK memiliki risiko 13 kali lebih tinggi mengalami persalinan preterm bila dibandingkan dengan kehamilan tanpa ISK.
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