Background: Vitamin D (25OHD) deficiency has become a modern-day epidemic, being the most common nutritional deficiency worldwide. Many infertile men are experiencing low total sperm count or different semen abnormalities. The aim of this study was to compare serum vitamin D (25OHD) status among fertile and infertile men.Methods: This was an observational (cross sectional comparative) study and was conducted in the Department of Reproductive Endocrinology and Infertility, BSMMU, Dhaka, Bangladesh during the period from April 2019 to March 2020. The sample size was 112 men where 56 participants were in fertile men group and 56 participants were infertile men group. Statistical analyses were carried out by using Windows based Statistical Package for Social Sciences (SPSS, version 23.0).Results: The predictability of vitamin D insufficiency was significant. Holding the effects of vitamin D deficiency constant, males with vitamin D insufficiency were 3.28 times more likely to be infertile than males with vitamin D sufficiency. Subgroup analysis of infertile men was done regarding semen parameters in different vitamin D status categories. There was statistically significant difference in semen volume and sperm concentration between infertile men of different vitamin D status but no significant difference in case of motility and morphology.Conclusions: There was no significant different of serum vitamin D (25OHD) between fertile and infertile men. Men with vitamin D insufficiency (≥20 ng/ml to <30 ng/ml) are more likely to be infertile than men with vitamin D sufficiency.

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Background: The objective of the study was to explore the correlation and discordance of anti-mullerian hormone (AMH) and follicle stimulating hormone (FSH) in the selected population of premature ovarian insuffiency and diminished ovarian reserve.Methods: This was a retrospective analysis of the data obtained from the women who presented to the Gynae Endocrine Clinic of the Infertility unit of the Department of Obstetrics & Gynaecology from 2015 to 2017. Discordance was defined as abnormal basal FSH (>10 IU/l) with assuring AMH (>1 ng/ml). Statistical analysis was done with SPSS version 23.Results: There were 36 women with premature ovarian insufficiency and 35 women with diminished ovarian reserve. The correlations between basal FSH and AMH are not significant. AMH values are relatively higher in younger age groups. There are extreme high outliers in both POI and DOR groups, more in younger age group. The discordance between AMH and basal FSH was more in women categorized to have diminished ovarian reserve, compared to women with premature ovarian insufficiency.Conclusions: Those women who are younger than 35 years and have high FSH combined with reassuring AMH should be counseled with care regarding the prognosis of their treatment.

Background: Ovarian aging may be reversible. Platelet rich plasma (PRP) has growth factors that promote cellular proliferation and folliculogenesis. Recently published studies and case reports suggest that ovarian rejuvenation can be done by PRP treatment. The objective of the study was to evaluate the effect of platelet rich plasma on ovarian reserve markers such as anti mullerian hormone (AMH) and antral follicle count (AFC) in sub fertile women with poor ovarian reserve (POR).Methods: The self-controlled quasi experimental study was carried out on 29 sub fertile women with poor ovarian reserve. They were selected for laparoscopic tubo-peritoneal evaluation as they could not afford in vitro fertilization. During laparoscopy, 5 ml of pre prepared autologous PRP was injected into each ovary. Post-PRP AMH and AFC were measured at every cycle for a period of at least three (3) months and compared with base line values.Results: Mean age of participants was 35.9±3.2 years. Baseline AMH was 0.31±0.17 ng/ml and baseline AFC was 3.41±0.73. AMH was raised on first, second and third cycle from base line values in 58.62%, 86.21% and 91.30% of the study population respectively. AMH changes in all three cycle were statistically significant. Pregnancy occurred in three (10.34%) women during the study period.Conclusions: The injection of autologous PRP into human ovaries is a safe procedure to improve ovarian reserve markers (AMH and AFC) in women with POR.

Background: Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive age women and it is a common cause of infertility in young women. Most of the infertile women with PCOS are overweight or obese. Obesity or excess fat aggravates the endocrine and metabolic dysfunction in women with PCOS. Weight management is the first line measure advised to infertile PCOS women who are overweight or obese. The objective of the study was to explore the association of obesity with the clinical, endocrine and metabolic parameters in infertile women with polycystic ovary syndrome in Bangladesh. Methodology: This was a cross sectional study of 126 consecutive infertile women with polycystic ovary syndrome attending the Infertility unit of the Department of Obstetrics and Gynecology at Bangabandhu Sheikh Mujib Medical University from January 2017 to December 2017.Obesity groups were defined by BMI thresholds specific for the South Asian population. Results: The mean body mass index (BMI) was 26.58±3.18 kg/m2and mean waist circumference was 91.07±9.5 cm. There was highly significant association of obesity with waist circumference and fasting insulin. BMI at or above 25kg/m2 was significantly associated with acanthosis nigricans, hyperandrogenemia and hyperinsulinemia, whereas BMI at or more than 23kg/m2 was significantly associated, in addition, with insulin resistance and metabolic syndrome. Conclusion: Obesity is associated with hyperandrogenemia, hyperinsulinemia, insulin resistance and metabolic syndrome in infertile women with polycystic ovary syndrome. Bangladesh Journal of Medical Science Vol.20(4) 2021 p.864-870

Introduction: Polycystic ovary syndrome (PCOS) affects 5-10% of reproductive age women and it is a common cause of infertility in young women. Most of the infertile women with PCOS are overweight or obese with related risks of insulin resistance, dyslipidemia and metabolic syndrome. There is ethnic variation in the prevalence of obesity and its related metabolic abnormalities in women with polycystic ovary syndrome. This study was designed to explore the prevalence of insulin resistance, dyslipidemia and metabolic syndrome in infertile women with polycystic ovary syndrome in Bangladesh. Methods: This was a cross sectional study of 126 infertile women with polycystic ovary syndrome attending the Infertility unit of the Department of Obstertrics and Gynaecology at Bangabandhu Sheikh Mujib Medical University from January 2017 to December 2017. Results: The mean BMI was 26.58±3.18 and mean waist circumference was 91.07±9.5 cm. Regarding the prevalence of obesity, 47.6% of the women were overweight (BMI 23 - 27.5 kg/m2), 39.7% was obese (BMI>27.5 kg/m2) and central obesity (waist circumference ≥80 cm) was in 80.2%. In infertile women of PCOS, the prevalence of insulin resistance was 27.8% , dyslipidemia 93.7% metabolic syndrome 42.9% .Median fasting insulin was higher than the cut off for insulin resistance specific for south Asian population. Insulin resistance measured by hyperinsulinemia was much more frequent (65.9%) than that measured by HOMA-IR (27.8%).The most common lipid abnormality was low HDL cholesterol (90.5%) followed by elevated LDL-cholesterol (79.4%). Low HDL cholesterol (90.5%) and abdominal or central obesity (80.2%) were the most common criteria of metabolic syndrome. There is increasing trend in metabolic syndrome with age. Conclusion: Screening the infertile women with polycystic ovary syndrome for insulin resistance, dyslipidemia and metabolic syndrome is important because it allows for additional counseling about long term health consequences and emphasis on weight management. J Bangladesh Coll Phys Surg 2021; 39: 225-232

Although misoprostol is widely used in Obstetrics and Gynaecology it is not officially approved for these uses. The literature review shows its efficacy and safety in most of its indications. Misoprostol is effective in cervical priming and inducing uterine contraction and so used in termination of pregnancy. Its use at term can be complicated with serious side effects on uterine contractility and fetal heart rate , rarely causing uterine rupture and fetal death. But review of the studies finds limited reports of these life-threatening complications. Misoprostol is also effective in prevention of postpartum haemorrhage but the effect is not more than combination of oxytocin and ergometrine. Key words: Misoprostol; prostaglandin; clinical use. DOI: 10.3329/jdmc.v18i1.6311 J Dhaka Med Coll. 2009; 18(1) : 75-78

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 vitamin D level is 16.75+5.75 ng/ml in males with oligospermia and 19.83+5.33 ng /ml in males with normozoospermia. By the threshold defined, all the infertile males are deficient in vitamin D. The difference between the circulating levels of vitamin D in the two groups is statistically significant (p<0.05). VitaminD deficiency is 4.25 times more in infertile males with oligospermia than in males with normozoospermia. Conclusion: Vitamin D deficiency is associated with oligospermia in infertile males. J Bangladesh Coll Phys Surg 2022; 40: 253-256