A slow freezing/rapid thawing method for the cryopreservation of human oocytes has been employed using a sodium-depleted culture media. In 53 frozen egg-embryo transfer (FEET) cycles, a 60.4% survival rate post-thaw was obtained and a 62.0% fertilization rate following intracytoplasmic sperm injection. Overall pregnancy rates were 26.4% per thaw attempt, 30.4% per patient, and 32.6% per embryo transfer. Pregnancy rates using sodium-depleted phosphate-buffered saline (PBS) as the base medium were 20.0% per thaw, 21.7% per patient, and 26.3% per transfer. With sodium-depleted modified human tubal fluid (mHTF) as the base for the cryopreservation medium, rates were 32.1% per thaw attempt, 39.1% per patient, 37.5% per transfer. The overall implantation rates were 4.2% per thawed oocyte and 13.6% per embryo, (PBS: 3.0% per egg, 10.6% per embryo; mHTF:5.3% per oocyte; 15.9% per embryo). These data indicate that the use of a sodium-depleted media with slow freezing and rapid thawing can yield acceptable pregnancy rates after FEET.

Background: Competence in laparoscopic skills is important for all gynaecological surgeons. Most residency programmes teach technical skills in the operating room and through lectures, where the evaluation of surgical skills is usually done through subjective evaluation. After graduating residency, most surgeons depend on themselves to decide if they are competent in performing a certain procedure. The objective of this study is to evaluate the accuracy of surgeon self-assessment compared with expert assessment of competence in laparoscopic surgical skills. A double-blind prospective cohort study was undertaken at Prince Hamza Hospital between January 2016 and April 2016 in Amman, Jordan. Eight practicing gynecologists and obstetricians performed and recorded 88 laparoscopic procedures including ovarian cystectomy, salpingectomy for ectopic pregnancy, salpingoophorectomy, resection of endometriosis, adhesiolysis and ovarian drilling. Participating gynecologists recorded the procedures and were asked to complete a Global Rating Index of Technical Skills (GRITS) evaluation after the surgery testing across multiple areas with a lowest score of 8 and a highest score of 40. Two well-versed laparoscopic experts in objective structured assessment of technical skills (OSATS) also independently scored all procedures using the same parameters. The correlation coefficient and internal consistency were calculated. Results: The GRITS score was calculated for each participant with a mean assessment score of 3.47 for each parameter. Participants self-assessment scores were significantly higher than expert assessment scores (p<0.05). The correlation coefficient was calculated and it can be seen that there was high inter-expert correlation in assessment across all participants evaluations (ICC > 0.90). Conclusion: Self-assessment of surgical laparoscopic skills is higher than expert evaluation of these technical skills. Quality assurance measures need to be revisited and restructured through more frequent assessments using peer and expert assessment alongside self-assessment. Gynecologists also need to undergo proper assessment prior to starting independently performing procedures that require new skills.

Objectives: Human papillomavirus (HPV) infection is the leading sexually-transmitted infection (STI) worldwide and the main etiology of cervical cancer. HPV infection rates are important in directing vaccination policies and screening for cervical cancer. Unfortunately, no recent reports have evaluated the prevalence of this infection among Jordanian women despite major globalization-driven changes in sexual behavior. Accordingly, this study aimed to determine the prevalence of HPV infection and its genotypic distribution in the cervical samples of Jordanian women. Materials and Methods: The study was carried out at Prince Hamza Hospital (Amman, Jordan) during 2016-2017. Women (15-75 years old) were randomly selected for cervical cell collection. DNA was extracted and then amplified using MY09/11 and GP5+/6+ consensus primers. Finally, positive samples were genotyped by applying real-time-polymerase chain reaction and reverse line blotting. Results: Fourteen out of 348 women tested positive for HPV with a prevalence rate of 4%. In addition, multiple HPV genotypes were observed in 36% (5/14) of infected women while single HPV genotype infection was found in 64% (9/14) of infected women. Further, high-risk (HR), potential high-risk (pHR), and low-risk (LR) HPV genotypes were detected in most cases with a 78.6% (11/14) infection rate, 42.9% (6/14), and 7.1% (1/14) of infected women, respectively. Eventually, 10 different genotypes were detected in infected women and HPV 16 was the most common type (42.9%, 6/14). Conclusions: Our data suggest that the prevalence of HPV infection among Jordanian women is below the global and regional rates. It is hoped that these data should facilitate the implementation of appropriate cervical cancer screening and future HPV vaccination programs.

Biometric fetal parameter measurements may be reproducible by different operators in the clinical setting with similar results. Fetal head circumference, abdominal circumference and femur length were highly reproducible. Large organized studies are needed to ensure accurate fetal measurements due to the important clinical implications of inaccurate measurements.

No abstract

Objective: To analyze different factors influencing positive pregnancy rate (PPR) and live birth rates (LBR) following in vitro fertilization (IVF). Materials and Methods: Between January 2009 and December 2015, a total of 1,451 embryo transfer (ET) cycles were performed at the Fertility Unit at Jordan University Hospital. Only the first fresh cycles (1,025) were included. Data were collected from the unit registry. Results: PPR was achieved in 44.3% (n=454) of cycles, while live birth rate was 36.9% (n=378). PPR and LBR in women younger than 35 years of age was 47.5% and 33.5, respectively. In women aged 35-39 years, PPR was 27.6% while LBR was 15.6%, and for women older than 40 years PPR and LBR, it was 10.9% and 4.7%, respectively. Causes of infertility did not affect PPR or LBR. The maximum percentage of live birth was achieved when 11-15 oocytes were retrieved (39.4%) and when three embryos were transferred (36.9%). Live birth rate was not affected significantly by the number of embryos transferred. Conclusion: Women's age is the main determinant of live birth rate after IVF. Cause of infertility did not affect live birth rate.

abstract:Rectovaginal fistulae after sexual intercourse are rare. We report a healthy recently married 21-year-old woman who presented to the Jordan Healthcare Centre, Amman, Jordan in 2014 with a five-week history of passing flatus and stool from the vagina. Six weeks prior, she had sustained a rectovaginal injury during initial consensual sexual intercourse, leading to the development of a distal rectovaginal fistula. A successful transvaginal repair was performed nine weeks after presentation which resulted in the complete resolution of her symptoms.

No abstract