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.
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
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