Murizah Mohd Zain - Academia.edu (original) (raw)

Papers by Murizah Mohd Zain

The Medical journal of Malaysia, 2020

Background: In reproductive medicine poor ovarian response (POR) among women undergoing in vitro ... more Background: In reproductive medicine poor ovarian response (POR) among women undergoing in vitro fertilisation (IVF) is of great concern. Meta-analysis showed that Dehydroepiandrosterone (DHEA) administration resulted in a significant increase in the number of oocytes retrieved in women with POR. The aim of this study was to assess the effectiveness of DHEA supplementation on IVF outcomes among poor responders undergoing IVF. Methods: Sixteen patients who were diagnosed with POR scheduled to undergo their second cycle of Intracytoplasmic sperm injection (ICSI)/embryo transfer cycle were enrolled. All enrolled patients had earlier undergone their first ICSI/embryo transfer cycle at least four months prior to this study. All subjects were given DHEA supplementation of 25mg three times daily for at least three months prior to their second ICSI/embryo transfer cycle. Statistical analysis of various ovarian response and ICSI outcomes parameter were compared pre and post DHEA. Results: Sixteen women with the mean age of 35 years were enrolled in the study. The comparative analysis of results showed a significant increase in the number of good quality of embryos obtained (p<0.05). After the treatment with DHEA, there was an improvement in the number of oocytes retrieved, Metaphase II (MII) oocyte (mature) oocytes obtained, fertilised and transferrable embryos and the pregnancy rate. There was no significant effect of DHEA treatment on the number of days of stimulation and cumulative dose of gonadotrophins used. Conclusion: Our results is able to show that DHEA supplementation may help to enhance IVF-ICSI outcomes in women with POR especially in those age 35 years and below.

Fertility and Sterility, Feb 1, 2009

Objective: To determine the first-line medication to be used in anovulatory patients with polycys... more Objective: To determine the first-line medication to be used in anovulatory patients with polycystic ovary syndrome (PCOS) for ovulation induction and pregnancy achievement. Design: Randomized controlled trial. Setting: Infertility unit of a public hospital. Patient(s): One hundred fifteen newly diagnosed patients with PCOS based on ESHRE/ASRM criteria. Intervention(s): These patients were assigned to three groups: group 1 (38 patients) received 500 mg of metformin three times a day; group 2 (39 patients) received clomiphene citrate (CC) at an incremental dose; group 3 (38 patients) received both medications. Main Outcome Measure(s): Rates of ovulation, pregnancy (PR), and live birth. Result(s): The ovulation rate was 23.7% in the metformin group, 59% in the CC group, and 68.4% in the combination treatment group. This was translated into a similar PR and live birth rate, which were higher in the CC and combination groups compared to the metformin group (PR: 7.9%, 15.4%, and 21.1%; live birth rate: 7.9%, 15.4%, and 18.4% in metformin, CC, and combination treatment groups, respectively), although statistically the differences were not significant. There were no multiple pregnancies and the rate of spontaneous first trimester loss was similar to the general population. Conclusion(s): Clomiphene citrate should be the first-line treatment for ovulation induction in anovulatory patients with PCOS.

Current Women's Health Reviews, Oct 30, 2014

OHVIRA syndrome, is a rare in-utero developmental defect affecting the female urogenital system, ... more OHVIRA syndrome, is a rare in-utero developmental defect affecting the female urogenital system, classically described as obstructed hemivagina and ipsilateral renal anomaly. Majority of the patients have clinical presentations of abdominal or pelvic pain, usually shortly post-menarche. Early detection and prompt treatment relieve symptoms and prevent complications. Similar presentations may be due to other entity of Mullerian abnormalities associated with single renal agenesis. Three cases illustrating the clinical presentations, the dilemma in achieving diagnosis and the treatment advocated for the patients. Case 1 is a classic OHVIRA syndrome while the other 2 cases are variants of the classic syndrome; the second case showed a contralateral renal agenesis and the third case had variants of Mullerian anomaly. High index of suspicion can help in the diagnosis of this rare OHVIRA syndrome, and there are possibilities of discovering new rare syndromes yet to be named.

2023 IEEE 13th International Conference on Control System, Computing and Engineering (ICCSCE)

Fertility and Sterility, 2007

Objective: To determine which first-line medication is more effective in polycystic ovary syndrom... more Objective: To determine which first-line medication is more effective in polycystic ovary syndrome (PCOS) patients for ovulation induction and pregnancy achievement and to verify whether any patient characteristic is associated with a better response to therapy. Design: Observational comparative study. Setting: Fertility clinic. Patient(s): One hundred fifty-four infertile women with oligomenorrhea and hyperandrogenism. Intervention(s): Group 1 (56 patients) received clomiphene citrate (CC) 50 mg from days 5-9 of the cycle. Group 2 (57 patients) received 500 mg of metformin 3 times a day. Group 3 (41 patients) received both medications. Main Outcome Measure(s): Ovulation and pregnancy. Result(s): Patients receiving metformin alone had an increased ovulation rate compared with those receiving CC alone (75.4% vs. 50%). Patients on metformin had similar ovulation rates compared with those in the combination group (75.4% vs. 63.4%). Pregnancy rates were equivalent in the 3 groups. Response to metformin was independent of body weight and dose. Finally, nonsmoking predicted better ovulatory response overall as well as lower fasting glucose for CC and lower androgens for metformin. Conclusion(s): Metformin is better for ovulation induction than CC alone and equivalent for pregnancy achievement. We suggest that metformin can be used first for ovulation induction in patients with PCOS regardless of their weight and insulin levels because of its efficacy and known safety profile.

Applied Sciences

The development of intelligence-based methods and application systems has expanded for the use of... more The development of intelligence-based methods and application systems has expanded for the use of quality blastocyst selection in in vitro fertilization (IVF). Significant models on assisted reproductive technology (ART) have been discovered, including ones that process morphological image approaches and extract attributes of blastocyst quality. In this study, (1) the state-of-the-art in ART is established using an automated deep learning approach, applications for grading blastocysts in IVF, and related image processing techniques. (2) Thirty final publications in IVF and deep learning were found by an extensive literature search from databases using several relevant sets of keywords based on papers published in full-text English articles between 2012 and 2022. This scoping review sparks fresh thought in deep learning-based automated blastocyst grading. (3) This scoping review introduces a novel notion in the realm of automated blastocyst grading utilizing deep learning application...

Gazzetta Medica Italiana Archivio per le Scienze Mediche, 2020

BacKGroUnd: the aim of this study was to evaluate the ivF/icSi outcome in endometriosis patient w... more BacKGroUnd: the aim of this study was to evaluate the ivF/icSi outcome in endometriosis patient who received Gnrh analog as downregulation prior control ovarian stimulation (coh). MethodS: a retrospective study involving 86 women with endometriosis who had undergone ivF at our center between January 2015 till december 2017. the clinical pregnancy rate analyzed as the primary endpoint. other outcomes measured include the total dose gonadotropin, the duration of stimulation, the number of oocytes retrieved, the number of Mii oocytes, the number of grade 1 embryo, number of embryo transfer and frozen, fertilization and cancellation cycle rate. reSUltS: three groups were analyzed including stage ii (n.=26), stage iii (n.=27) and stage iv (n.=31). the clinical pregnancy rate higher in stage ii compares to stage iii and iv (69.2% vs. 37% vs. 38.7%). Surprisingly, they also had more follicles, oocytes retrieved and MII oocytes. The number of grade 1 embryo also significant seen in stage II compared to stage iii and iv with p-value 0.006 (3.15±2.3 vs. 2±1.49 vs. 1.63±1.40). Women with stage iii and iv endometriosis required a higher dose of endometriosis significantly (2781.94±835.57 and 2708.73±962.07) compared to stage ii (2052.40±620.79). the duration of stimulation is almost similar in all stages of endometriosis. there was a similar result seen in the number of embryos transferred. A more frozen embryo is seen in stage II endometriosis significantly. conclUSionS: Gnrh analogue integrated with coh protocol is recommended as a proper stimulation protocol for endometriosis especially in stage ii endometriosis.

Journal of Pharmacy Practice and Community Medicine, 2017

Objective: To evaluate the effectiveness of the consumption of Profortil ® , a combination of eig... more Objective: To evaluate the effectiveness of the consumption of Profortil ® , a combination of eight micronutrients, on sperm count, sperm motility, and pregnancy outcomes following a fertility intervention among infertile males in Malaysia. Methods: A cohort study was undertaken at the Seberang Jaya Hospital and the Sultanah Bahiyah Hospital, Malaysia. A total of 90 infertile males were enrolled, 52 of which decided to take two capsules of Profortil ® daily for a six-week period during 1 st September and 30 th November 2016. Those who decided not to consume Profortil ® served as the control group (n=38). Semen analysis and an observation of pregnancy outcomes following the fertility interventions were conducted after 6 weeks. Results: Despite the consumption of Profortil ® , both groups showed a significant increase in sperm count (p<0.001), but no change in sperm motility after 6 weeks. Although the difference in increment of sperm count between two groups was not significant, more participants who took Profortil ® achieved a sperm count above 15 million/mL (25% versus 18.4%). The Profortil ® group also demonstrated a higher pregnancy rate following the fertility interventions (26.9% versus 18.4%). Conclusion: The findings suggest that Profortil ® could be helpful in improving the sperm parameters and pregnancy outcomes. Nevertheless, to optimize its effectiveness, a longer supplementation duration is likely to be needed.

Hormone Molecular Biology and Clinical Investigation, 2019

Background To determine whether a minimal stimulation (MS) or high-dose stimulation (HDS) protoco... more Background To determine whether a minimal stimulation (MS) or high-dose stimulation (HDS) protocol is a better option for patients classified as poor ovarian responders (POR) in terms of reproductive and pregnancy outcomes. Materials and methods A database search for evaluation of the study outcome by using meta-analysis method was carried out. The primary outcome was the clinical pregnancy (CP) rate for each of two groups, namely, the MS and HDS groups. The secondary outcomes were the gonadotropin dose used, duration of stimulation, cancellation rate, number of oocytes retrieved, number of fertilized oocytes, number of embryos transferred and live birth rates. Results Across five databases, 4670 potential studies for further screening were selected. But ultimately only six studies, three RCTs and three retrospective or case control studies were selected that meet the Bologna criteria for POR. In all there were 624 cycles. Our meta-analysis indicated that the CP rates, cycle cancell...

International braz j urol : official journal of the Brazilian Society of Urology

International braz j urol : official journal of the Brazilian Society of Urology, Jan 18, 2016

A typical male looking adolescent with a legal female gender assignment presented with haematuria... more A typical male looking adolescent with a legal female gender assignment presented with haematuria. Investigations led to the diagnosis of Persistent Mullerian Duct Syndrome. The condition is indeed a rare entity that needs a multidisciplinar team management. Case hypothesis: A case of Persistent Mullerian Duct Syndrome undiagnosed at birth because karyotyping was defaulted, thus resulting in a significant impact on the legal gender assignment and psychosocial aspects. Promising future implications: The reporting of this case is important to create awareness due to its rarity coupled with the rare presentation with hematuria as a possible masquerade to menstruation. There were not only medical implications, but also psychosocial and legal connotations requiring a holistic multidisciplinary management.

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2013

The premature ovarian failures with underlying chromosomal abnormalities are normally X-linked, a... more The premature ovarian failures with underlying chromosomal abnormalities are normally X-linked, although their associations with the autosomal and the Robertsonian translocations are also possible. Here, we are reporting a case of premature ovarian failure which was associated with a translocation between the long arm of chromosome 7 at q11.23 and the short arm of chromosome 5 at p15.3. The proband was a 26-year-old Malay woman who presented with premature ovarian failure, who was referred for cytogenetic testing due to the suspicion of a chromosomal anomaly. Her physical examination revealed that she had no abdominal or pelvic masses and that she had normal secondary sexual characteristics. Her medical history as well, revealed no points for concern. However, a consanguineous relationship existed, as the patient's paternal grandmother and maternal grandfather were biological cousins. Our present case indicated that region p15.3 of chromosome 5 and region q11.23 of chromosome 7 possibly carried essential genes for the ovarian function and that they postulated a link between the consanguinity and the chromosomal abnormalities.

Open Journal of Obstetrics and Gynecology, 2013

Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomip... more Background: The purpose of this study was to compare the effectiveness of Letrozole versus Clomiphene citrate for ovulation induction in polycystic ovarian syndrome (PCOS) with infertility. Methods: This was a prospective randomized trial involving 150 women with PCOS attending the Infertility Clinic at three hospitals in Malaysia. During the initial visit, anthropometric measurements and baseline investigations were performed. Patients were randomized to 5.0 mg Letrozole daily (75 patients) or 100 mg Clomiphene citrate daily (75 patients) from the fifth until the ninth day of menstruation. Serial transvaginal scans were performed to see the dominant follicles, endometrial thickness and number of follicles. Transvaginal scans were performed serially to look for evidence of ovulation. Results: The subjects were homogenously distributed. The difference between Letrozole and Clomiphene citrate for ovulation rate was 59 (78.7%) versus 40 (53.3%). Patients taking Letrozole exhibited a mean endometrial thickness (ET) at mid cycle of menses (Day 11-D14) of 9.2 mm (SD ± 2.3) versus 8.4 mm (SD ± 2.2) for patients taking Clomiphene citrate, and these differences were statistically significant (p < 0.001). In terms of pregnancy rate, Letrozole facilitated pregnancy induction in 19 patients (25.3%) versus 12 patients (16.0%) for Clomiphene citrate; however, this was not statistically significant (p = 0.22). More dominant follicles exhibiting a monofollicular morphology were observed in patients treated with Letrozole compared to patients treated with Clomiphene citrate, with a monofollicular dominant follicle observed in 33 (46.5%) versus 20 (26.7%) patients, respectively. Conclusion: Letrozole provided a more efficient stimulation compared to Clomiphene citrate in terms of ovulation induction, thickening of the endometrial lining and achievement of a successful pregnancy. Clinical Trials. gov Identifier: NCT015-77017.

Women's Health, 2008

Obesity and overweight are common conditions that have consequences not only on general health bu... more Obesity and overweight are common conditions that have consequences not only on general health but also to a great extent on reproductive health. There is a high prevalence of obese women in the infertile population and numerous studies have highlighted the link between obesity and infertility. Obesity contributes to anovulation and menstrual irregularities, reduced conception rate and a reduced response to fertility treatment. It also increases miscarriage and contributes to maternal and perinatal complication. Reduction of obesity, particularly abdominal obesity, is associated with improvements in reproductive functions; hence, treatment of obesity itself should be the initial aim in obese infertile women before embarking on ovulation-induction drugs or assisted reproductive techniques. While various strategies for weight reduction, including diet, exercise, pharmacological and surgical intervention exist, lifestyle modification continues to be of paramount importance.

Journal of Pediatric and Adolescent Gynecology, 2012

Background: Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), or Herlyn-Werner-Wunder... more Background: Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA), or Herlyn-Werner-Wunderlich syndrome, is a rare Mullerian duct anomaly with uterus didelphys, unilateral obstructed hemivagina, and ipsilateral renal agenesis. Patients with this anomaly usually present after menarche with pelvic pain and/or a mass and rarely, in later years, with primary infertility. Strong suspicion and knowledge of this anomaly are essential for a precise diagnosis. Case: A 14-year-old female presented with acute retention of urine and was diagnosed as a case of OHVIRA syndrome with uterus didelphys. Acute retention of urine as the initial clinical presentation has been rarely reported in this syndrome. She was treated with hemivaginal septal resection. Summary and Conclusion: OHVIRA syndrome should be considered among the differential diagnoses in young females with renal anomalies presenting with pelvic mass, symptoms of acute abdomen, and acute urinary retention.

Journal of the ASEAN Federation of Endocrine Societies

CONCLUSION There is a high dropout rate (59%) with only 41% retention in our weight management pr... more CONCLUSION There is a high dropout rate (59%) with only 41% retention in our weight management programme. There may be multiple factors associated with this occurrence. Our study showed that those with known dyslipidemia and those with baseline BMI of more than 40 kg/m 2 were more likely to complete the programme and benefit from it.